mo hit assistance center rural hospital presentation
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Your Answer to All Things EHR
Federally-designated Regional Extension Center for the State of Missouri
University of Missouri: Department of Health Management and InformaticsCenter for Health PolicyDepartment of Family and Community Medicine
Partners:Hospital Industry Data Institute (Small Rural and Critical Access Hospitals)Kansas City Quality Improvement OrganizationMissouri Primary Care AssociationMissouri Telehealth NetworkPrimaris
Vision: Assist Missouri's health care providers in using electronic health records to improve the access and quality of health services; to reduce inefficiencies and avoidable costs; and to optimize the health outcomes of Missourians
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FinancialFinancial
Organization ChangeOrganization Change
• Expense of system• Uncertainty around ROI• Provider and staff productivity• Uncertainty about financial incentives
• Disruption of workflow and productivity• Privacy and security concerns• Maintaining patient centeredness and
satisfaction
•Concerns about technically supporting a system•Lack of necessary computer skills •Finding the right EHR to suit practice needs
(“usability”)•Having the right IT staff in place•Possibility of information overload
TechnicalTechnical
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Require significant support to carry out proper workflow re-design
Result can be piecemeal and less effective use of EHR capabilities and fewer financial and quality benefits Substantial time spent customizing forms and redesigning
workflow More time spent with patients leading to longer workdays
or fewer patients during the initial period Overburdened planning and implementing without
additional technical support
MEDICARE
Doctors of medicine or osteopathy, doctors of dental surgery or dental medicine, doctors of podiatry, doctors of optometry and chiropractors who participate in the physician fee schedule (PFS)
General rule of thumb, MDs or Osteopaths who bill under Medicare Part B are likely eligible.
No volume requirement
MEDICAID
Doctors of medicine or osteopathy only (in some limited cases optometry
Nurse practitioners Certified nurse-midwifes Dentists EPs must have 30%
Medicaid patient volume to qualify (20% for pediatricians)
EPs must choose Medicare or Medicaid Incentives
Professionals who “practice predominantly” in an FQHC or RHC may use “needy individual” volume to meet their 30% threshold A professional must have more than 50% of
encounters that occurred at an FQHC/RHC over a six-month period
CMS defines “needy individuals” as patients who: Receive medical assistance from Medicaid or the
Children’s Health Insurance Program; Are furnished uncompensated care by the provider; or Are furnished services at either no or reduced cost
based on a sliding scale
MEDICARE
Acute care (or subsection d) hospitals paid under the Medicare Inpatient Prospective Payment System (IPPS)
Critical Access Hospitals
(CAHs)
MEDICAID
Acute care hospitals
Children’s hospitals
Cancer hospitals
Critical Access hospitals Requires 10% Medicaid
patient volume to qualify (except Children’s hospitals)
Hospitals qualify for both Medicare and Medicaid incentives
Priority: Primary care providers, including physicians (Internal Medicine, Family Practice, OB/GYN, Pediatrics) and other health care professionals (NP, PA) with prescribing privileges in the following settings:
•Small group practices (10 or fewer providers with prescriptive privileges•Ambulatory clinics connected with a public or critical access hospital•Community health centers and rural health clinics•Other ambulatory settings that predominately serve uninsured, underinsured, and medically underserved populations
55 Critical Access and Rural Hospitals
The Missouri Hospital Association through the Hospital Industry Data Group (HIDI) has the responsibility of working with Critical Access Hospitals to achieve Milestones 1, 2, and 3. Individual providers receive services through the HIT Assistance Center.
Population - 5,874,327
Primary Care Providers - 5300
Priority PCPs - 2400
Priority PCPs Served - 1167
Total Providers - 17,946
CAH and Rural Hospitals - 55
Team of experienced, Missouri based Health IT professionals
Part of a national network designated by HHS to assist providers with modernizing their practices
Direct, rapid and reliable access to a pipeline of key information on health IT and meaningful EHR use
For providers who do not have a certified EHR system - We help you choose and implement one in your office
For providers who already have a system - We help eligible providers meet the Medicare or Medicaid criteria for incentive payments
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RHC recruited as pilot site based relationship Their desires - support resolving challenges:
Increase patient throughput Resolve IT infrastructure issues Reduce no-shows Decrease time wasted looking for patient-information Increase point of care documentation Improve reporting and management of chronic/preventive
care Command attention from the vendor
Additional observations: Improve staff satisfaction related to EHR use and adoption Improve communication between clinicians and staff
Recommendation focusing on three key areas: 1. Patient throughput
Ensure the E H R supports patient flow Encourage point of care documentation(at least meaningful use
documentation) Reduce patient waiting time
2. User experience Improve system performance – uptime and speed Consistency in documentation and work steps Arrange training for all E H R Users Improve document management and scanning process
3. Data reporting Enhance management reporting capabilities Decrease time spent in data collection activities Implement Meaningful Use tracking tool
Top 3 Priorities were determined after consulting with staff and physicians
Address the issues related to point of care documentation
Command attention from vendor leadership Coordination between IT vendor and practice Practice administrator hired Training on certified version Adopting modified workflow - define process and role Conclusion – total value of REC is TBD but one Physician
reduced the time of chart completion from two weeks to one day
Continuing Education and Training for ALL Providers
Vendor Selection and Group Purchasing Group Purchasing Vendor Selection
EHR Implementation and Project Management Practice Workflow Analysis and Redesign
Practice Readiness Assessment Change Management Workflow Re-Design
Functional Interoperability and HIE Resources for Health Information Exchange Security Risk Analysis
Help Providers Achieve “Meaningful Use”
Website: http://ehrhelp.missouri.edu MO HealthNet EHR Incentive Program
website: http://www.dss.mo.gov/mhd/ehr
CMS EHR Incentive Program website: https://www.cms.gov/EHRIncentivePrograms
HIT Assistance Center E-Mail: [email protected]
Phone: 1-877-882-9933